Telemedicine Adoption and the Connectivity Challenge

NVTC’s latest guest blog post is by Stefano Migliorisi, CEO and founder of swyMed, a provider of patented technology that expands telemedicine care to places where it was previously unavailable, powering truly mobile exceptional-quality live video encounters, even at the lowest bandwidths. Migliorisi participated on the Telemedicine and Remote Patient Monitoring Panel at the Capital Health Tech Summit on June 15. View full video from the panel below.

Telemedicine allows patients and doctors to connect over a distance. The industry has been growing tremendously, with the U.S. market valued at $4.9 billion in 2015 and projected to reach $6.7 billion in 2020. Others estimate the sector is significantly larger, depending on which technologies are included and how much of the infrastructure and staffing/services are included in the definition of telehealth, but the one constant is the trend of explosive growth.

In many rural and underserved areas, specialists are in short supply; just getting to the doctor’s office, which is far away in a larger city, and back home again can take an entire day. Instead, telemedicine allows a patient to remain at a local clinic for a virtual visit with the same physician, which is considerably less time consuming and more economical both for patients and healthcare providers.

Telemedicine enables specialists to “beam” themselves into underserved communities via a broadband internet connection, and can have a transformative impact on reducing cost, improving patient compliance and improving outcomes. However, many regions across the country still lack broadband Internet connections sufficient to deliver quality care virtually.

Regardless of whether patients are logging in on their home computers, data-enabled smartphones, or wireless tablet devices, one thing is generally needed: a reliable high-speed Internet connection. We typically think of this as a challenge in rural areas, but a similar dynamic plays out in urban environments, where networks can become congested.

Telemedicine Uses

Telemedicine has been effective in helping patients to better manage chronic conditions. Advances in home health care have made it possible for patients to connect with their healthcare providers from the comfort of their living rooms, improving rates for follow-up visits and treatment regimen compliance. Digital devices such as pulse oximeters, blood pressure monitors and scales can automatically send data from a patient’s home to a care manager’s desktop, where he or she can monitor the patient’s status, prioritize interventions and initiate an audio-video call where follow-up is warranted. This technology has proven particularly successful for treating chronic diseases such as diabetes.

Similar data has emerged from skilled nursing facilities (SNF) where it has been demonstrated that patient well-being and outcomes are improved, transports to the emergency room (ER) reduced and total system costs lowered dramatically by establishing a telemedicine link between the SNF and the ER. This is particularly valuable during nights and weekends, when the SNF is less likely to have a staff doctor available. Having click to call access to a local ER, allows the patient to receive a consultation, the SNF staff to have confidence that the patient is getting the appropriate level of care, and more often than not avoids a transfer to the ER which has significant cost and staffing implications for the SNF, the ER and the health care system as a whole.

Connectivity Remains a Challenge to Telemedicine

It has been estimated that 70% of face-to-face medical encounters COULD be delivered as telemedicine encounters. As more and more potential applications of the technology are piloted and evaluated, connectivity and reliability are emerging as critical factors to overcome before virtual video care can be relied upon as a primary channel to deliver care.

* Connectivity – Telemedicine relies on Internet connectivity to function, but the same rural regions tend to have the largest physician shortages and the most barriers to Internet access. The lack of broadband infrastructure impedes both real-time services such as video visits and store-and-forward technologies, leaving a gap in coverage for patients in these areas.

* Reliability – Telemedicine requires uninterrupted connections to prevent missed instructions or possible patient mismanagement. If systems are not reliable, or need to be restarted several times in the course of a patient encounter, trust in the system on the part of providers, patients and healthcare workers will be diminished. When telemedicine is used for acute diagnoses such as telestroke diagnosis and treatment, every minute of delay can negatively impact patient outcomes with significant long term consequences.

Numerous approaches, both from established video communication companies as well as newer market entrants have arisen to address the emerging connectivity and reliability challenges. These approaches include everything from reducing the size and quality of image transmission, to new compression algorithms, and enhancing broadband signal availability with mobile communications hotspots, to development of data transport mechanisms that can operate over low bandwidth while still delivering high quality imagery.

View full video of the panel below:

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